Module 04: Sleep Module 04: Sleep
Module 04: SLEEP This module includes the following sections: Key Messages Common Sleep Challenges Medications and Sleep Tips from Families for Getting a Good Night s Sleep Activities for Better Sleep Getting enough sleep is important for good physical and mental health. Not getting enough sleep can lead to: Sleepiness during the day Irritability Difficulty paying attention or problem solving Hyperactivity Mood changes (e.g. crankiness) Difficulty learning things and remembering Weight gain
2 Key Messages 1. The amount of sleep needed is different for everyone While most children (aged 5-12) need between 10-11 hours of sleep a night and most adolescents need approximately 9-10 hours of sleep a night, the amount of sleep needed is different for everyone. The most important question is whether your child is feeling well-rested during the day and has enough energy to go about their daily activities. Warning signs that your child is not getting enough sleep include: 2. The first step to getting a good night s sleep is having good sleep hygiene (sleep habits) Feeling tired in the mornings or after lunch Falling asleep in school Having difficulty concentrating or remembering Feeling more irritable than usual Having less energy than usual The key ingredients of good sleep hygiene are: Going to bed at the same time every night and waking up at the same time every morning. Being consistent is very important Avoiding caffeine (e.g. soda, tea, coffee, chocolate) Using your bedroom only for sleep and not for studying or other activities. The sleep environment should be boring and not associated with stimulating activities (T.V., music, computer, work). This boring sleep environment sends a signal to the brain to prepare the body for sleep
M o d u l e 4 : Sleep 3 2. (cont...) Avoiding heavy exercise in the evening Avoiding bright light 1-2 hours before bed. This includes the computer and other screen activities Making sure that the sleep location is comfortable and quiet 3. Medications and some mental health conditions can impact sleep A Sleep Tips for Kids resource sheet can be found in the Tools & Resources section. Talk to your health care professional if you have questions about how medications or mental health conditions may be impacting your child s sleep. Some additional information can be found in this module.
4 Common Sleep Challenges Sleep difficulties are common in children and youth with mental health challenges. Difficulties can include problems falling and staying asleep, waking up too early, having a decreased need for sleep, nightmares, fear of the dark, and worry. Many difficulties can be helped by having good sleep hygiene (sleep habits). However, other problems may be related to your child s mental health condition, the medication they are on, or to a medical condition. If this is the case, additional treatment may be required. If your child or youth is having difficulty sleeping, or is complaining of sleepiness during the day, always discuss this with your health care professional. Nightmares Nightmares are scary dreams that wake up your child. Here are some things you could try if your child has nightmares: Avoid frightening images before bedtime (e.g. scary stories, movies or T.V. shows) Make sure your child is getting enough sleep. Sometimes sleep loss leads to nightmares If your child gets out of bed, take them back to their bed and briefly comfort them there. Keep further discussion of the nightmare until the morning Reassure your child that it was only a dream Have your child draw a picture of the bad dream and then throw it away. Write the story with a happy ending, or keep a dream journal
M o d u l e 4 : Sleep 5 Bedtime Struggles Bedtime struggles include not wanting to go to bed, or not being able to fall asleep without the help of another person, object or situation. If your family is dealing with bedtime struggles, make sure your child has the same bedtime routine every night. This routine should be short and sweet. It should always move in the direction of your child s bedroom. A picture chart, on which routine activities are listed and then checked off by your child when completed, can be helpful. If bedtime struggles continue, talk with your health care professional. Adolescents and Sleep It may be a relief for parents to know that teenager s biological clocks naturally shift towards later times for both falling asleep and waking up. This means that teenagers want to stay up later and sleep in later. Teens may struggle to function on a schedule that is out of sync with their internal clock. As a result, they may be constantly sleepy. Teens naturally want to stay up later and sleep in on the weekend, but this catch-up sleep on the weekends can make their sleep cycle even more out of sync. Here are some specific tips for teenagers who are having difficulty sleeping: Weekday and weekend wake-up times should not be more than 2 hours apart: the later the weekend sleep-in, the harder it will be to fall asleep the next night Discuss with your teen a good way to wake them up in the morning. This can help avoid any conflict in the mornings Avoid all nighters: remind your teen that their memory and concentration will be better when they ve had a good night s sleep Using stimulants (e.g. caffeine, nicotine) to fight sleepiness can make it harder to fall asleep; marijuana use has also been linked to sleep problems Using electronics (e.g. cell phones, video games, T.V.) 1-2 hours before bed time can disrupt sleep Bright light in the morning can help teens become more awake, and outdoor light can help reset the body clock For more information on teens and sleep: www.slideshare.net/teenmentalhealth/why-teens-need-their-sleep-presentation
6 Medications and Sleep Medications used to help treat some mental health conditions can disrupt a child or youth s sleep. Small changes in the time your child takes their medication can be helpful for getting a good night s sleep. Talk to your medical professional if you would like to discuss the effects of your child s medication on sleep. Melatonin Melatonin is a neurohormone naturally found in our bodies. It regulates our internal body clock and sleep cycles. For some children and youth, taking melatonin as a part of their treatment plan might help them to get a better night s sleep. Melatonin is a natural chemical that can help to regulate sleep cycles For certain mental health conditions, melatonin may reduce the amount of time it takes to fall asleep. It may also lengthen the time one stays asleep, and increase daytime alertness. However, melatonin may not be effective for some children and youth and may interact with certain medications or supplements. Also, based on your child s age and the medication they are on, they may need a specific dose. You should always talk to your medical professional before giving melatonin to your child. From: Using Melatonin in Children and Adolescents, BC Children s Hospital For more information on melatonin: http://keltymentalhealth.ca/treatment/medications CHECK WITH YOUR DOCTOR BEFORE STARTING YOUR CHILD ON MELATONIN Melatonin can interact with certain medications, and is not helpful for all sleep difficulties. You should always talk to your medical professional before giving melatonin to your child Other Medications for Sleep Difficulties Other medications that can help with sleep difficulties in children and youth exist. Speak with your doctor about other medications that may be helpful.
M o d u l e 4 : Sleep 7 Tips from Families for Getting a Good Night s Sleep These tips have been developed by families, for families through a series of focus groups across B.C. Keep in mind that not all tips are appropriate for all families if you have questions about a specific concern, talk to your family doctor or other health care professional. Sleep Hygiene Keep a regular sleep schedule If your child is hungry, let them have a snack before bed (e.g. a bowl of cereal with milk) Decrease the amount of stimulating activities at night (e.g. T.V. or computer/internet activities, video games) Relaxation Teach your child different ways to relax Use relaxation CDs (nature sounds, Zen garden, waterfalls, etc.) Listen to white noise, a fan, radio, or classical music Try meditation or yoga Give your child a foot massage or rub their back If your child worries at night Have a book by the bed so that your child can write/draw what they were thinking or worrying about. The next day, you and your child can talk about what was written/drawn in the book Have a worry stone in a small soft bag that your child can rub to soothe themselves Other strategies for specific mental health conditions Some children with autism may benefit from sleeping with a heavier blanket. This may give them the pressure they need to calm down. NOTE: Talk to your health care professional before trying this, as this may not be suitable for all children Sleeping low (e.g. putting your child s mattress on the floor) may help some children
8 Activities for Better Sleep 1. Relaxation Children and youth may not realize how much tension they store in their bodies. Helping them to relax before they go to sleep can help them get a better night s sleep. One way to relax is called visualization. This is when your child imagines themselves in a more relaxed place. We have included quick relaxation activities, including visualization and deep breathing, on the Quick Ways to Relax resource sheet in the Tools & Resources section. 2. Talking Through the Worries of the Day Before your child goes to sleep, take a few minutes to discuss any difficult moments of the day. Try using a bubble blower to blow worries away and then watch the bubbles pop. You can also have your child write down their worries on the Stress in My Day activity sheet (found in the Tools & Resources section). After discussing them, have your child crumple up the paper and toss it into the garbage can. 3. Create a Bedtime Routine Chart As a family, create a chart that has pictures of the bedtime routine (e.g. have a snack, have a bath, brush teeth, read a story) and the days of the week. Try to follow this routine every night. Have your child check off the activities as you complete them. An interactive bedtime routine chart is also available from the Kelty Mental Health Resource Centre website (http:// keltymentalhealth.ca/healthy-living/bedtime-routine)